NPIMap

Organization Active NPI

Dr. Stuart L. Graves, DDS, Ms, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Burke, VA
National Provider Identifier
1124164108
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
DR. STUART L. GRAVES, DDS, MS, PC
Practice address
5206 Lyngate CT
Burke, VA 22015-1631
Phone
(703) 425-5010
Fax
(703) 323-7287
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Sara Smith
Title
Office Administrator
Phone
(703) 425-5010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

5206 Lyngate CT
Burke, VA 22015-1631

Mailing address

5206 Lyngate CT
Burke, VA 22015-1631
Phone (703) 425-5010

National Provider Directory

National Provider Directory

Locations

5206 Lyngate Ct
Burke, VA 22015
Phone (703) 425-5010

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124164108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5206 LYNGATE CT",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151631",
            "telephone_number": "703-425-5010",
            "fax_number": "703-323-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5206 LYNGATE CT",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151631",
            "telephone_number": "703-425-5010",
            "fax_number": "703-323-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. STUART L. GRAVES, DDS, MS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "703-425-5010",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.